Publication - Advice and guidance

The Joint Appointments Guide 2014: An updated guide to setting up, managing and maintaining joint appointments between health organisations and local government in Scotland

Published: 21 Jan 2014
Part of:
Health and social care
ISBN:
9781782568261

This is a second edition of the Scottish Guide, updated (in 2013) to relect the current legislative context.

38 page PDF

888.1 kB

38 page PDF

888.1 kB

Contents
The Joint Appointments Guide 2014: An updated guide to setting up, managing and maintaining joint appointments between health organisations and local government in Scotland
Sustaining a Joint Appointment

38 page PDF

888.1 kB

Sustaining a Joint Appointment

Critical Success Factors

6. Induction
7. Performance management
8. Training, development and personal support

Critical Success Factor 6: Induction

Where partnerships are relatively new organisations joint appointees will play a key role as the partnership develops.

To do this well it is vital that joint appointees have an understanding of the culture of the partner organisations. This means understanding not just the relevant structures, processes and governance, but also how it feels to work there. For example: is it a very mechanistic and rule bound organisation; is it very hierarchical; does it take managed risks or is it very cautious and controlled; does it exploit opportunities to learn and develop or does it seek out fault and apportion blame when things go wrong; are staff expected to experiment, use initiative, develop ideas and work across departments? If the joint appointee doesn't have this understanding of at least one organisation then the learning curve may be too steep. The induction needs to help with this. Induction is also a particular priority in a joint appointment because the risk of the joint appointee becoming detached and isolated is higher than in more conventional appointments.

Induction is as much about introducing the post into the partner organisations and explaining how it will work as introducing the person. Joint appointees are more likely to work with a great deal of flexibility and autonomy, which means that there is a higher risk of confusion and, sometimes, resentment among colleagues who are managed differently. Support and effort from the senior management of partner organisations to help the joint appointee become known to the staff is important and helps to establish the credibility of the joint appointee.

An effective induction is not merely a quick walk about with another member of staff, nor is it solely a series of appointments with colleagues during the first weeks in the job. It starts with an initial plan developed by the person responsible for recruitment, and then evolves and is shaped by the post holder. It should be seen as a key responsibility of both the manager and the post holder to ensure that a proper and adequate induction takes place. The induction period should stretch over a longer period of time than the first day or week. This is particularly important when the appointee has little or no experience of the organisational culture in a health service or local government environment.

The induction should include an introduction to the systems and processes of the organisations. It is vital that the joint appointee understands, for example, how decisions and policy are made and who is involved in this process; what information is routinely collected by each organisation; and the organisation's strategic objectives and implementation plan and how their role contributes to these. The induction should also explain the key relationships with relevant stakeholder organisations and the community.

Good practice note

There are a range of tools which can be used as part of an induction package:

  • shadowing staff at various levels
  • attending decision-making meetings
  • holding a 10-minute lunchtime introductory meeting to describe the post to members of staff within each organisation
  • emailing an introduction to everyone, in all partner organisations, of who they are and where they will be located
  • driving or walking around the local area
  • carrying out a few interviews with
    key staff and stakeholders to identify the range of expectations of what the appointee will be doing and aiming to achieve
  • visiting service delivery points
  • making the joint appointee's contact details available in partner organisations and including the post on organisational charts

Critical Success Factor 7: Performance management

The research indicated that in a surprising number of cases joint appointees had not had access to systematic performance management. This is despite the fact that all partner organisations probably operate a performance management system as a matter of course in more conventional appointments.

Performance management of the post holder is very different to performance management of the joint appointment. Specifically, the joint appointee needs a line manager while the joint appointment needs a strategic steer and a group responsible for monitoring and evaluating the effectiveness of the joint appointment as a mechanism for achieving a set of shared strategic objectives. Here, we focus specifically on the performance management of the joint appointee. Performance managing how well the strategic aims of the appointment are being met is considered in the next section, 'Sustaining the Partnership'.

Joint appointees need to be given the flexibility and autonomy to develop the post. Tight and controlling management is unlikely to provide this.

However, they also need a set of clear performance indicators linked to the objectives of the post, and regular time (perhaps a monthly meeting) with the manager to reflect on how these are being achieved and what is helping and hindering.

The requirement for joint accountability, and its implications for management, is a particular issue. For more junior appointments the problem often manifests as 'no-one takes responsibility - I've been pushed from pillar to post.' At a more senior level, maintaining accountability to more than one governance structure can be challenging, although this can be mitigated by sharing and clarifying expectations of the post early in the planning stage. It is important also to take account of different governance mechanisms, cultures and expectations within the different organisations.

Performance indicators

In many cases, the particular challenge that a joint appointment presents is the determining of appropriate targets and performance indicators. This is a difficulty inherent in 'measuring success' in partnership working in general.

As with any good performance management system, joint appointees need to be helped to set objectives emerging from the overall strategic purpose of the joint appointment and then, together with the line manager, to develop performance indicators as appropriate. Training and development needs should also be part of this process.

In agreeing performance indicators it is important to remember that the performance of the joint appointee in terms of achievements can be dependant on a number of other prerequisites, such as the clarity of the purpose of the post, shared expectations and objectives, commitment from partner organisations, effective line management and so on. Performance management needs to be mindful of these wider success factors and use line management meetings to reflect on their presence and stability.

Quarterly reports to the strategic management group by the joint appointee and the line manager were identified by participants in the research as a useful way to ensure proper interaction between the operational performance of the joint appointee and the strategic performance of the joint appointment.

Shared priorities and targets

Most post holders talked of the need for work in developing targets and priorities aligned between and across organisations. This process needs to flow from the broad scoping of the purpose and aims of the post, otherwise, as one of our interviewees noted: 'Despite joint targets, there is a tendency for agencies to do their own thing and expect their own things to be my priorities.' These targets need to be monitored and reviewed by effective and regular management interventions.

Good practice note

As with all partnership working it is important to be rigorous in ensuring that the performance indicators set relate to outcomes as opposed to inputs. It is easy to fall into the trap of measuring 'inputs', e.g. partnership contacts (meetings, forums, events and so on) as opposed to outcomes, such as partnership actions resulting in a tangible benefit for service users, for example development of shared stakeholder standards for the monitoring of service X. Joint appointees who are not helped to differentiate in this way can end up feeling demotivated and that they are not achieving.

'In my case the partners should have spent more time distinguishing between aspirations and achievable realities.'

Frustration and confusion arises when the post holder finds himself or herself with too many masters and conflicting instructions.

'For a while one organisation did try and manipulate me to work to their advantage, the whole arrangement was suffering, but my line manager took it to the partnership board. It wasn't easy but it got sorted out!'

Line management

Management arrangements will have a significant impact on a joint appointment's success. Rarely, and only at senior levels, did the original research find a joint appointee who was satisfied with remote and infrequent management from the partner organisation. Joint appointees need the confidence to take these posts forward but also need line managers to be a sounding board for progress and development.

'My management is not helpful really, it's mainly by email and meetings once every couple of months.'

'My main concern is that my line manager is mainly interested in daily issues, not strategy and there is little about me, it's all about the post!'

Joint line management seems to be particularly effective when regular progress and review meetings are scheduled - perhaps once every month - and where the relevant managers from each organisation meet with each other and the post holder, with space for current issues to be dealt with. These sessions should consider both the operational performance of the joint appointee in relation to delivering on the objectives of their post and the strategic objectives of the appointment. Structured feedback should be offered and time made available for problem solving or agreeing approaches if necessary.

Good practice note

It is crucial in joint appointments that we differentiate between how the appointment is managed and where the appointee is accountable. The fact that the appointee will have multiple accountabilities does not necessarily mean that he or she needs to be managed in multiple places. However, when one partner takes responsibility for day-to-day line management arrangements it is easy to lose sight of the dual, or even multiple, accountability. The key to managing in the context of multiple accountabilities is that the line manager operates within a clear strategic framework set by all the partners.

'Joint meetings are a good idea, but finding time all individuals can make is a nightmare. We set ours up twelve months ahead now.'

These meetings are more effective if they follow an agenda of standard issues, progress against objectives, difficulties, training and development, etc.

The line manager needs to be selected carefully. He or she will need an understanding of what is required in the role and how this can best be achieved. It need not necessarily be someone with a different professional background to the joint appointee, although such a person may offer a different professional perspective and make it less likely that the joint appointee will be seen to be 'owned' by the organisation in which they or their manager is located.

'I think managers who take on this role need to understand the subtle differences to single organisation posts - maybe some training or something before they take the role on.'

The line manager needs to be someone who is not too close to the objectives of the post. A line manager with a lot to lose or gain may seek, or merely be perceived as seeking, to shape the post holders approach to their organisation's advantage. When tensions, competing demands, different expectations or conflicts occur between organisations it may be difficult for line managers close to the work to manage the joint appointee objectively. The manager should be someone with a reputation for integrity and absolute fairness.

'I often feel pulled in different directions when my manager focuses on his own organisation's priorities rather than the partnership's.'

Some joint appointees have found themselves being managed by people on a lower salary than themselves, with potential consequences for the management relationship. This is likely to be more of a problem within very hierarchical or bureaucratic organisations where status/power and earnings are closely correlated. This is not necessarily the case in all organisations.

Location of line manager

A number of the joint appointees we spoke to suggested that line management in the more 'familiar' organisation works best, at least at the start of the post. Others disagreed, suggesting that this may impede the extent to which the individual feels at home within, and is perceived as equally 'owned' by, all organisations.

Good practice note

Providing some freedom and flexibility is not the same as suspending sound, standard managerial processes. For example, the freedom to shape objectives and design more flexible targets or more qualitative measures of performance should not mean that we suspend the need to determine objectives and define performance indicators altogether. If anything, the fluid nature of joint appointments and the relative absence of standard 'fixed points' call for more rigorous attention to these sorts of managerial processes.

'I am from a social care background and so is my manager. With hindsight I think I should have had a manager from health as this reinforced the perception that I belonged to social services. It didn't really help strike a balance or consolidate joint working.'

An appointee from a health background, for example, may welcome line management from the local authority, or vice versa, as a quick way of getting up to speed with the culture of the new organisation, and to avoid being seen as belonging to one organisational culture while trying to make inroads into the other.

As both views were widely endorsed, it is probably necessary to decide the appropriate location of line management on a case-by-case basis.

Supervision

Professional supervision or accountability may be important or necessary for joint appointees in some professional groups, i.e. supervision from someone at a more senior level within the profession, who oversees continuing professional development and is accountable for the joint appointee's professional performance. This may be true, for example, of nursing or clinical staff. In such cases, the line manager, the professional supervisor and the joint appointee need to meet to clarify the expectations of each and to establish the content and mechanisms for communication between them.

In some cases there is also a requirement for statutory supervision. These issues need to be considered during recruitment.

'To be honest, I have found it difficult as a nurse employed by the local authority to retain my professional autonomy in this unfamiliar environment.'

Flexibility

Our research suggests that introducing an element of flexibility into the management and maintenance of joint appointments can be effective. The nature of the post can change over time - in its objectives, priorities, accountability arrangements and so on - and managers need to recognise and allow for this aspect. Particularly with more senior post holders, the structures of joint management and accountability have been flexible and fluid, allowing the post holder to achieve objectives: '(management is by) memos of agreement rather than anything more specific'. Allowing the post holder some space and freedom to determine their own workload and shape areas of work can relieve some pressure from what may be a very intensive role. Licence to be creative and innovative is also important; working across organisations can expose staff to new challenges and ideas that can be developed or shaped to the advantage of the post.

Critical Success Factor 8 Training, development and personal suport

The original research showed that a resilient personality is required to cope with joint appointments, particularly at more junior levels. Practice-level or front-line posts did not tend to attract the same senior level commitment or interest as planning or strategy-level posts. Training and development and personal support were often inadequate or overlooked in these roles, as post holders were not necessarily able to 'shout loudly' for these needs to be addressed. With pressures coming at the joint appointee from various directions, particularly for more junior posts, the post holder may suffer competing and even conflicting demands and he or she needs to be supported in managing this reality.

'When they appointed me they knew I was on a fairly steep learning curve but my development needs were never mentioned again after the interview and offer of the job. Looking back, I wish I had pushed for it; in many ways I learned the hard way through mistakes.'

Personal support

Irrespective of the level of seniority of the post, all joint appointees will benefit from being part of a network of joint appointment peers. Joint appointees have said that they often feel isolated in their roles. They may fit into neither organisational culture and feel that they are not part of either organisation. They may also find themselves in possession of confidential information they are unable to share with their line manager. Some of the challenges that present themselves are unique to joint appointments and are not generally understood. It may sometimes feel like a thankless job, as the successes are often about enabling the success or achievements of others.

Even where systems and management arrangements are in place to support joint appointees, it is often the lack of personal assistance and advice on a day-to-day level which is particularly problematic. Interviewees referred to 'the lack of support and protection generally'.

For these reasons, it is important for joint appointees to have support from others in similar roles who understand the nature of the experience and who can offer mutual support and shared approaches to managing the difficulties that arise. The original interviewees emphasised the importance of accessing networks of support and talking to people holding similar posts in either an informal or a formal way. Time and space for reflection on practice, and forward planning, perhaps through retreats or partnership away days, was also thought important.

'It can often feel very isolated and like no-one really appreciates what it is you do - having said that I love it and would sometimes just like to share with someone else who understands what it's like.'

Some partnerships have found it helpful to develop a portfolio or network of joint appointments, to provide mutual support in a structured and formalised way. These could operate within a local authority or health board area, city or nationally, or could be client based and draw joint appointees together across the community for mutual support and professional development.

Joint appointees should also be encouraged to utilise existing professional organisations and networks for support. Time and resources for attendance at events, conferences and seminars should be provided to allow post holders to begin to identify these networks.

Training and development

Many joint appointees feel that the kinds of training and development that would be helpful for them were not easily available.

'If I needed training in Excel Spread-sheets I could get that easily but it's not really what I need.' In particular, training and information were sought on:

  • policy issues, changes and legislation within a particular sector
  • joint working
  • conflict management
  • consensus building
  • leadership skills
  • community development techniques
  • developing reflective practice evaluation
  • political skills
  • negotiation and influencing skills.

It should be clear to joint appointees what resources are available to them for training and support. The budget should be identified early in the recruitment process and training needs identified at the point of recruitment, then fine-tuned with the appointee soon after they take up the post.

As the number of joint appointments continue to increase it may be cost effective to pool resources from partner organisations to fund training and development.

Employers should encourage research and development budget holders to allocate resources to the provision of the kind of training and development required by joint appointees.

There are few exemplars or blueprints for working effectively in a joint appointment. It is likely therefore that development and support opportunities will take the form of learning sets or coaching, which offer opportunities for mutual support, shared learning and problem solving.

Mentoring

Joint appointees in middle or senior level roles may benefit from having a mentor to act as a sounding board and advisor, who can help the joint appointee develop ways to respond to and manage challenges and be reflective on their practice. This needs to be someone who is suitable for the role but who is also impartial, i.e. has no stake in the objectives of the post. Ideally this person will be someone independent of the employing organisations.


Contact

Email: Kate Thomas